Neoplasms

Symptoms and General Pathology

All Conditions

Gland and Hormone Related Diseases

Diseases and Abnormalities at or Before Birth

Musculoskeletal Diseases

Blood and Lymph Conditions

Neoplasm Metastasis

Thyroid Diseases

Congenital Abnormalities

Thyroid Neoplasms

Bone Neoplasms

Bone Marrow Diseases

Neoplastic Processes

Endocrine System Diseases

Endocrine Gland Neoplasms

Head and Neck Neoplasms

Bone Diseases

Hematologic Diseases

All Drugs and Chemicals

Antibodies

Immunoglobulins

Evaluation of month and year of birth, sex, referent doctor and surgeon

Administrative data

Evaluation of diagnostic circumstances, vital status at last follow up

Clinical data

Evaluation of Pathology report of thyroid surgery

Histological data

Imaging data

Evaluation of thyroglobulin, antithyroglobulin antibodies

Biological data

Evaluation of surgery, radiotherapy, targeted therapy

Further treatment

Claire BOURNAUD, MD

Claire MARX

Bone radioiodine (RAI) uptake without structural abnormality in thyroid cancer (TC) patients may be related to false positive or to microscopic foci of metastatic tissue. In such cases, outcome is reported to be excellent.

Indeed, Robenshtok et al. reported a serie of patients with RAI-avid bone metastases of TC without structural abnormality on imaging studies who have more favorable long-term prognosis than those harbouring structurally visible bone metastases and do not undergo skeletal-related complications.

The investigators report the case of Mrs D., who had been operated for a pathologic tumor stage 3: pT3(m) poorly differentiated TC at the age of 43. The first post-therapeutic whole body scan revealed 3 foci of bone uptake (right clavicle, L2, L3). The elevated level of thyroglobulin (157ng/mL) favoured the hypothesis of bone metastases despite the absence of any structural lesion on CT and MRI. She received 7 courses of radioiodine therapy. The right clavicle RAI uptake persisted, and subsequent CT disclosed an osteolytic lesion which was treated by radiofrequency and external beam radiation. Twenty-five years after the diagnosis, she has a persistent morphological disease with a 30x8mm progressive lesion on the right clavicle, for which surgery is planned.

The aim of the present study is to describe the natural history and evolution of radioiodine avid bone metastases from thyroid cancer without structural abnormalities and to identify prognosis factors.

Radioiodine-avid Bone Metastases From Thyroid Cancer Without Structural Abnormality

Radioiodine-avid Bone Metastases From Differentiated Thyroid Cancer Without Structural Abnormality, a Singular Entity With Heterogeneous Outcomes.

* Disappearance of pathologic radio iodine uptake, including bone uptake, on post-therapy scintigraphy
* No structural evidence of disease on high-resolution imaging
* Suppressed serum Tg \< 0.6 ng/mL, no detectable TgAb (thyroglobulin antibody)

Hospices Civils de Lyon

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Radioiodine-avid Bone Metastases From Thyroid Cancer Without Structural Abnormality	NCT04141306	Bone Metastases Thyroid Cancer	Administrative ... Clinical data Histological da... Imaging data Biological data Further treatme...	18 Years - 80 Years	Hospices Civils de Lyon
Radioiodine-avid Bone Metastases From Thyroid Cancer Without Structural Abnormality	NCT04141306	Bone Metastases Thyroid Cancer	Administrative ... Clinical data Histological da... Imaging data Biological data Further treatme...	18 Years - 80 Years	Hospices Civils de Lyon

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